Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $185.05 / $398.11 / $2,505.14	Facility		$185.05	$398.11	$2,505.14
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $877.08 / $2,181.78 / $2,953.60	Facility	25	$877.08	$2,181.78	$2,953.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.28 / $239.91 / $721.63	Professional		$181.28	$239.91	$721.63
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $201.71 / $341.23 / $1,046.07	Professional	25	$201.71	$341.23	$1,046.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $200.06 / $258.81 / $382.74	Professional		$200.06	$258.81	$382.74
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $202.11 / $255.63 / $457.72	Professional	25	$202.11	$255.63	$457.72
BCBS Facility/Professional Facility Modifier Low / Median / High Price $492.98 / $844.66 / $1,263.91	Facility		$492.98	$844.66	$1,263.91
BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.79 / $282.27 / $338.05	Professional		$239.79	$282.27	$338.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $286.33 / $286.33 / $286.33	Facility		$286.33	$286.33	$286.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $212.04 / $311.86 / $504.10	Professional		$212.04	$311.86	$504.10
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $240.19 / $379.44 / $1,287.33	Professional		$240.19	$379.44	$1,287.33
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $252.50 / $269.23 / $368.56	Professional		$252.50	$269.23	$368.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $385.57	Professional		$32.34	$32.34	$385.57
United Facility/Professional Facility Modifier Low / Median / High Price $1,875.37 / $1,875.37 / $2,929.38	Facility		$1,875.37	$1,875.37	$2,929.38
United Facility/Professional Professional Modifier Low / Median / High Price $238.38 / $340.21 / $584.29	Professional		$238.38	$340.21	$584.29